Rationing of hip and knee operations will become “routine” and waits get
longer and longer unless radical changes are made to the way NHS orthopaedic
surgery is organised, claims a leading surgeon.

The NHS faces being snowed under by an “avalanche” of demand for orthopaedic care, caused by Britain’s ageing and increasingly overweight population, said Professor Tim Briggs.

Some health authorities are already restricting access to hip and knee replacement operations, by making patients wait until they are less mobile and in greater pain.

Prof Briggs, former medical director of Stanmore orthopaedic hospital, said: “ If we are going to give patients the care they need, when they need it, we are going to have to do things very differently. If not, then rationing is going to become routine.”

The number of orthopaedic operations had increased from 47,000 in 2004 to 179,000 in 2011, according to the National Joint Registry, he said.

Patients were too often not being referred soon enough or to the right specialist, he continued, meaning there were many instances when “we are not getting it right first time”.

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Infection rates for orthopaedic operations - which lead to prolonged stays on wards and sometimes revision operations - were also too high in some hospitals.

At the best, just two in 1,000 orthopaedic patients acquired infections but in the worst the rate was 20 times higher, he said.

“If we brought the rate down to 0.2 per cent across the board he could save the NHS up to £300 million, which would allow us to do 60,000 extra joint replacements a year,” he argued.

Prof Briggs is highlighting his concerns today (Tuesday) at a parliamentary reception hosted by Stephen Dorrell, the Conservative MP and chairman of the Health Select Committee.

Meanwhile, a separate report has found the situation is improving for patients who have suffered hip fracture.

The National Hip fracture Audit found quicker access to surgery after a fall and better care management has led to shorter hospital stays. Now the average stay is 20.2 days, down a day on last year, saving the NHS £14 million.

Prof Briggs welcomed the audit, saying it was the result of focusing on problems in trauma care.

But he said: “Now with the numbers coming through for planned operations, we need a serious focus on elective orthopaedics.”

A Department of Health spokesman said: "A DH spokesperson said: "Waiting times for orthopaedic treatment are low. The figures for the first six months of 2012 show that the number of patients who waited longer than 18 weeks before starting treatment has fallen by nearly 9,000 compared with the same period in 2011.

"Last year we made it clear that it is unacceptable for the NHS to impose blanket bans for treatment on the basis of costs. This is particularly true for patients in pain. That is why we banned primary care trusts from putting caps on the number of people who could have certain operations."